Wish Registration Form 心愿登记表

*Limit 1 Wish for 1 family; 1个家庭限1个愿望

Please Take Note:
1. Submission of a wish does not guarantee its approval or fulfilment.
2. Each individual or family may submit only one wish for consideration. Duplicate or multiple submissions from the same household will not be accepted.
3. If your wish is chosen for consideration, you will receive a phone call from Great Heart Charity Association (in 1-2 weeks time) to run a simple assessment and you may be required to provide a few supporting documents.

请注意：
1. 提交愿望并不保证其获得批准或实现
2. 每个个人或家庭只能提交一个愿望供考虑。同一家庭的重复或多次提交将不被接受
3. 如果您的愿望被选中，您将接到耕心慈善机构的电话 (1-2周里的时间)，进行简单的评估，并可能需要您提供一些证明文件

Full Name 姓名 (required)

IC Number 身份证号码 (required)

Contact No. 电话号码 (required)

House Address 住家地址 (required)

Number of Household Members 家庭成员人数 (required)

What is your wish 你的愿望是什么？(required)

Reason for Wish 愿望的理由 (required)

Estimated Total Monthly Household Income (RM) 预计家庭每月总收入 (RM) (required)

List out any external aid received (if any) 列出收到的任何外部援助（如有)

Eligibility: Wish submissions are open to individuals residing in West Malaysia who meet the criteria of being resides below the poverty line, indigenous people, single-parent households, elderly individuals living alone, people with disabilities, as well as cancer or dialysis patients.
Submission Process: Wishes must be submitted through the designated platform, such as a Google Form, WhatsApp, or phone call. Each submission should include the wish details, including the specific item, service, or experience requested, along with a brief explanation of the need or reason behind the wish.
Verification: All wish submissions are subject to verification to ensure eligibility and authenticity. Additional information or documentation may be requested to validate the need for the wish.
Selection Process: Wish selection will be based on various factors, including feasibility, genuine necessity, and available resources.
Limitations: Each individual or family may submit only one wish for consideration. Duplicate or multiple submissions from the same household will not be accepted.
Privacy: Personal information provided during the wish submission process will be kept confidential and used solely for the purpose of wish fulfillment. By submitting a wish, individuals consent to the use of their information for this purpose.
Approval: Submission of a wish does not guarantee its approval or fulfilment. The organizing committee reserves the right to reject or modify wishes based on feasibility, budget constraints, or other considerations.
Notification: Selected individuals will be notified of the status of their wish via the contact information provided during the submission process. It is the responsibility of the wish submitter to ensure that their contact information is accurate and up to date.
Acceptance: By submitting a wish, individuals acknowledge and agree to abide by these terms and conditions. They also consent to the use of their name and appearance for promotional purposes related to the wish fulfilment event.
Discretion: The organizing committee reserves the right to interpret and enforce these terms and conditions at its discretion. Decisions regarding wish selection and fulfilment are final and not subject to appeal.
Modification: These terms and conditions may be subject to modification or update at any time without prior notice. Participants are encouraged to review the terms periodically for any changes.

By submitting the form, I acknowledge that I have read and understand the Terms and Condition written above.